What happens to unprepared root canal walls: a correlative analysis using micro‐computed tomography and histology/scanning electron microscopy

Aim To microscopically examine the cleanliness of root canal walls that remained unprepared as revealed by micro‐CT. Methodology The root canals of 10 freshly extracted mandibular premolars with necrotic pulps and apical periodontitis along with the mesiobuccal canals of 11 mandibular molars with vi...

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Published in:	International endodontic journal Vol. 51; no. 5; pp. 501 - 508
Main Authors:	Siqueira, J. F., Pérez, A. R., Marceliano‐Alves, M. F., Provenzano, J. C., Silva, S. G., Pires, F. R., Vieira, G. C. S., Rôças, I. N., Alves, F. R. F.
Format:	Journal Article
Language:	English
Published:	England Wiley Subscription Services, Inc 01-05-2018
Subjects:	cleaning and shaping Computed tomography Dental pulp Dental Pulp Cavity - diagnostic imaging Dental Pulp Cavity - pathology Dental Pulp Cavity - ultrastructure Dental Pulp Necrosis - pathology Dentistry endodontic treatment Endodontics histology Humans Lavage Mandible Microscopy, Electron, Scanning micro‐computed tomography Molars Periapical Periodontitis - pathology Periodontitis Premolars Root Canal Preparation Root canals Scanning electron microscopy Sodium Sodium hypochlorite Teeth X-Ray Microtomography cleaning and shaping scanning electron microscopy micro-computed tomography histology endodontic treatment
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Summary:	Aim To microscopically examine the cleanliness of root canal walls that remained unprepared as revealed by micro‐CT. Methodology The root canals of 10 freshly extracted mandibular premolars with necrotic pulps and apical periodontitis along with the mesiobuccal canals of 11 mandibular molars with vital pulps were prepared using Reciproc instruments R40 and R25, respectively, and 2.5% sodium hypochlorite irrigation. Specimens were scanned in micro‐CT before and after preparation, and the unprepared areas were identified. The outer root surface corresponding to the untouched areas was marked on each root third to guide further analysis using histological (for teeth with vital pulps) and scanning electron microscopic (SEM; for necrotic teeth) examination. In the teeth with vital pulps, the root canal area occupied by tissue remnants was calculated. In SEM analysis of teeth with necrotic pulps, scores were attributed for the amount of debris on the untouched areas. Results The proportion of unprepared areas in the mesiobuccal molar canals was 18.1% and 9.6% over the full canal length and apical canal, respectively. In premolars, corresponding figures were 34.6% and 17.6%, respectively. Histological analysis of canals with vital pulps revealed tissue remnants over the untouched walls almost exclusively in the apical canal. SEM analysis of the canals with necrotic pulps revealed debris along the untouched walls in all root canal thirds. Conclusion The areas that remain untouched by Reciproc instruments used with 2.5% NaOCl irrigation as revealed by micro‐CT analysis were usually covered with debris, in the form of pulp tissue remnants, bacteria and dentine chips, especially in the apical root canal.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0143-2885 1365-2591
DOI:	10.1111/iej.12753